The fetal safety of cetirizine: an observational cohort study and meta-analysis.

Cetirizine, a second-generation antihistamine, is an active metabolite of hydroxyzine used in the treatment of allergies, but the data on fetal safety are inconclusive. Pregnant women who were counselled by the 'Motherisk Program' regarding cetirizine exposure were enrolled in a cohort study and compared with pregnant women counselled for non-teratogenic exposures. The objective was to measure the rate of adverse pregnancy outcomes. Subsequently, we also conducted a meta-analysis of cohort studies that examined the pregnancy outcomes of women exposed to hydroxyzine or cetirizine during pregnancy. In the cohort study, there were no significant differences in the rates of major malformations between the cetirizine exposed and comparison group. In the meta-analysis, cetirizine was not associated with increased teratogenic risk. In contrast, a meta-analysis of cetirizine and hydroxyzine studies showed a marginal association with major malformations. Cetirizine is not associated with a clinically important increase in risk of adverse fetal outcomes.

Pregnancy outcome following use of large doses of vitamin B6 in the first trimester.

Vitamin B6 is often prescribed for the treatment of nausea and vomiting of pregnancy (NVP), at much higher doses than initially recommended. Large doses of vitamin B6 have been associated with cases of neuropathy. We set out to assess whether higher than standard doses of vitamin B6 during the first trimester of pregnancy were associated with a risk of maternal adverse events, major malformations, miscarriages or low birth weight. This was a prospective comparative observational study. The study group included women who were exposed to >50 mg/day of vitamin B6 during the first trimester; the control group included pregnant women with a non-teratogen exposure. A total of 192 pregnancies were followed-up. The mean dose of B6 used in the study group was 132.3 mg/day (median 110 mg/day, range 50 - 510 mg/day), for a mean period of 9 +/- 4.2 weeks. In this group (n = 96), there were 91 live births, one major malformation and the mean birth weight was 3,542 +/- 512 g. There were no statistical differences in the study endpoints between the vitamin B6 and the control groups. Within the limits of our sample size, higher than standard doses of vitamin B6 do not appear to be associated with an increased risk for major malformations.

Inheritance and interactions of incompatibility alleles in the tetraploid sour cherry.

Three progenies of sour cherry (Prunus cerasus) were analysed to correlate self-(in)compatibility status with S-RNase phenotype in this allotetraploid hybrid of sweet and ground cherry. Self-(in)compatibility was assessed in the field and by monitoring pollen tube growth after selfing. The S-RNase phenotypes were determined by isoelectric focusing of stylar proteins and staining for RNase activity and, for the parents, confirmed by PCR. Seedling phenotypes were generally consistent with disomic segregation of S-RNase alleles. The genetic arrangements of the parents were deduced to be 'Köröser' (self-incompatible) S1S4.S(B) S(D), 'Schattenmorelle' (self-compatible) S6S13.S(B)S(B), and clone 43.87 (self-compatible) S4S13.S(B)S(B), where "." separates the two homologous genomes. The presence of S4 and S6 alleles at the same locus led to self-incompatibility, whereas S13 and S(B) at homologous loci led to self-compatibility. The failure of certain heteroallelic genotypes in the three crosses or in the self-incompatible seedlings indicates that S4 and S6 are dominant to S(B). However, the success of S13S(B) pollen on styles expressing corresponding S-RNases indicates competitive interaction or lack of pollen-S components. In general, the universal compatibility of S13S(B) pollen may explain the frequent occurrence of S13 and S(B) together in sour cherry cultivars. Alleles S(B) and S(D), that are presumed to derive from ground cherry, and S13, presumably from sweet cherry, were sequenced. Our findings contribute to an understanding of inheritance of self-(in)compatibility, facilitate screening of progenies for self-compatibility and provide a basis for studying molecular interactions in heteroallelic pollen.

The reproductive effects of beta interferon therapy in pregnancy: a longitudinal cohort.

OBJECTIVE: To determine whether interferon therapy during human pregnancy increases reproductive risks in women. METHODS: This longitudinal, controlled cohort study consisted of three groups of women: an exposed group, a disease matched unexposed group, and a healthy comparative group. Subjects were selected from women contacting the Motherisk Program regarding maternal beta interferon exposure, mostly for multiple sclerosis during pregnancy, from 1997 to 2004. After delivery all of the women were re-contacted for a follow-up interview regarding maternal health, pregnancy outcome, and neonatal health. RESULTS: The study group (n = 16 women, 23 pregnancies) were exposed to interferon beta-1a (Avonex, Rebif) and interferon-1b (Betaseron). There was a decrease in mean birth weight in the exposed group (3,189 +/- 416 g) as compared to healthy controls (3,783 +/- 412 g, p = 0.002). Women exposed to beta interferon had a higher rate of miscarriages and stillbirths (39.1%) vs healthy controls (5%) (p = 0.03), even after correction for potential confounders. There were two major malformations (abnormality in the X chromosome, Down's syndrome) among exposed fetuses. CONCLUSIONS: Beta interferon therapy in the first trimester of pregnancy appears to be associated with an increased risk for fetal loss and low birth weight.

Validation studies of the Pregnancy Unique-Quantification of Emesis (PUQE) scores.

The Pregnancy-Unique Quantification of Emesis (PUQE) is a scoring system to quantify the severity of nausea and vomiting of pregnancy (NVP). Based on quantification of the 3 physical symptoms of NVP (nausea, vomiting and retching), PUQE closely correlates with the validated but much more complex Rhodes' score. We examined the ability of PUQE to predict four independent aspects of NVP: (a) pregnant women's ability to take multivitamins. (b) rates of emergency room visits and hospitalisation for NVP. (c) health cost of NVP. (d) women's self scores of well-being in NVP. Using large prospective cohorts of women for each end point, severity of NVP measured by PUQE had significant predictive value for all 4 aspects sought. PUQE has been validated through 4 independent clinical outcomes of direct importance and relevance for NVP. The simplicity of PUQE and the ease of its execution make it a practical tool for both clinical follow-up and research.

Identification of incompatibility alleles in the tetraploid species sour cherry.

The incompatibility genetics of sour cherry ( Prunus cerasus), an allotetraploid species thought to be derived from sweet cherry (diploid) and ground cherry (tetraploid), were investigated by test crossing and by analysis of stylar ribonucleases which are known to be the products of incompatibility alleles in sweet cherry. Stylar extracts of 36 accessions of sour cherry were separated electrophoretically and stained for ribonuclease activity. The zymograms of most accessions showed three bands, some two or four. Of the ten bands seen, six co-migrated with bands that in sweet cherry are attributed to the incompatibility alleles S(1), S(3), S(4), S(6, ) S(9) and S(13). 'Cacanski Rubin', 'Erdi Botermo B', 'Koros' and 'Ujfehertoi Furtos', which showed bands apparently corresponding to S(1) and S(4), were test pollinated with the sweet cherry 'Merton Late' ( S(1) S(4)). Monitoring pollen tube growth, and, in one case, fruit set, showed that these crosses were incompatible and that the four sour cherries indeed have the alleles S(1) and S(4). Likewise, test pollination of 'Marasca Piemonte', 'Marasca Savena' and 'Morello, Dutch' with 'Noble' ( S(6) S(13)) showed that these three sour cherries have the alleles S(6) and S(13). S(13) was very frequent in sour cherry cultivars, but is rare in sweet cherry cultivars, whereas with S(3) the situation is reversed. It was suggested that the other four bands are derived from ground cherry and one of these, provisionally attributed to S(B), occurred frequently in a small set of ground cherry accessions surveyed. Analysing some progenies from sour by sweet crosses by S allele-specific PCR and monitoring the success of some sweet by sour crosses were informative. They indicated mostly disomic inheritance, with sweet cherry S alleles belonging to one locus and, presumably, the ground cherry alleles to the other, and helped clarify the genomic arrangement of the alleles and the interactions in heteroallelic pollen.

The role of the placenta in variability of fetal exposure to cocaine and cannabinoids: a twin study.

There is wide variability in the reported adverse fetal effects of cocaine and cannabinoids. The causes of this variability are largely unknown. We hypothesized that variability in placental handling of drugs affect fetal exposure. We used twin pregnancies as a paradigm to address the role of the placenta in this variability. We analyzed hair or meconium samples taken from dizygotic and monozygotic twins exposed in utero to illicit drugs. Out of 12 pairs, 5 had negative levels in both twins, and seven pairs of twins had chemical evidence of fetal exposure to cocaine (n = 5) or cannabinoids (n = 2). The one known monozygotic pair of twins had almost identical levels of cocaine. In contrast, the six dizygotic pairs had large disparities in either cocaine or cannabinoid concentrations. In three of these six dizygotic pairs, levels of cocaine (n = 2) or canabinoids (n = 1) were undetectable in one twin while positive in the other. Given that twins are theoretically exposed to similar maternal drug levels, our findings suggest that the placenta may have a major role in modulating the amounts of drug reaching the fetus.

[Current results and methods in eradication of typhus fever on the Serbian territory excluding autonomic provinces]. / Dosadasnji rezultati i metode u eradikaciji pegavog tifusa na teritoriji Srbije van autonomnih pokrajina

Since 1969 Serbia has been conducting the programme of eradication louse-borne typhus. To this effect of Law on the eradication of communicable diseases has been passed. In addition to Republic Commission, as well as 6 regional commissions, and 18 communal commissions in whose territory the disease is being eradicated, have been formed. The operations consist of four phases: preparatory attack, consolidation and final phase. The methods and measures applied under the programme include the measures concerned with the control of vectors, i.e. lousiness, measures to detect the source of infection, respectively patients with louse-borne typhus and Brill-Zinsser disease. The control of louseiness effected through the impregnation of underwears and bed linens by means of syntheic insecticides (DDT, Maltox), as well as through health education activities, has yielded good results, so that the highest rate of lousiness: 9.08% (Sjenica, Tutin 4.37%), was reduced to less than 1% in 1972. To detect the source of infection, both active and pasiive investigation has been carried out. Active investigation included regular control of the health state through thermometry applied to registered households with lice. Passive investigation is carried out trough out -patient units and residential services which take care of all febrile patients coming from endemic areas. The results obtained from the three-year operations indicate that the percentage of dected patients with Brill-Zinsser amounts to 0--4--3.9%, as well as that it is still lagging behind with respect to the immunity acquired through previous affections in the endemic areas. The distribution of detected patients with Brill-Zinsser especially indicates that a small number of patients from endemic ares has been detected. The paper presents the criteria for the evaluation of results, making a proposal that a professional body should be formed at the federal level to coordinate the methods and programmes of operations. In addition that body's task would be to expand the operations to all endemic areas in the country.